The pharmaceutical industry is one of the largest income generating industries in the world. As revenue in this industry has steadily increased, it has become increasingly important to track the prescribing habits of individual physicians.
Currently, pharmaceutical outlets (“outlets”) record and store data pertaining to each pharmaceutical purchase by patients at such outlets. Outlets are more commonly known as drugstores or pharmacies. When a patient purchases pharmaceuticals from an outlet, the outlet collects data such as the patient's name, the pharmaceutical item dispensed (“Rx #”), the transaction date, the physician who prescribed the prescription (“Dr. #”), and other miscellaneous information.
As this transaction information is recorded in the outlet's database, the outlet typically assigns each patient an identification code (“outlet identifier”). An outlet identifier is used such that a patient's name can remain anonymous when such information is transmitted outside of the outlet. Since each outlet may be a drugstore, pharmacy, or chain thereof, outlet identifiers are not the same across multiple outlets. Further, where an outlet is a chain of drugstores, an outlet identifier may not even be the same across different stores of that same chain.
For example, if one outlet is pharmacy “ABC”, a regular consumer/patient John Doe may have an outlet identifier “00A” at pharmacy ABC. If John Doe then gets a pharmaceutical filled from drugstore XYZ, John Doe will general get a different outlet identifier, “001” for example, at pharmacy XYZ. Thus, even though John Doe is only one individual patient, if prescription data from both pharmacies are received by a central source, John Doe's records appear as that of two different patients because of the unlike identifiers across different outlets. Thus, based upon the currently available data it is very difficult to map and/or track the pharmaceutical prescriptions written for John Doe or by Joe Doe's physician because John Doe's records appear as two (2) different patients across multiple outlets.
Pharmaceutical benefit managers (“PBM”) are another group in the pharmaceutical industry that collect data. In particular, PBMs collect data that pertain to pharmaceutical sales that get resolved through insurance plans. For example, if a patient John Doe has a particular health insurance, “MNO” health insurance, and John Doe wishes to use his benefits under MNO to pay for all or part of his pharmaceutical purchase, data will then pass from the dispensing outlet to one or more PBMs of such transaction, as the transaction is cleared with the insurance company.
PBM data is similar to the outlet prescription data described above. PBM data typically includes an outlet identifier, Rx #, the transaction date, Dr. #, other miscellaneous information, and a patient identifier given by the pharmaceutical benefit manager. Although the pharmaceutical benefit manager can identify patients across a plurality of outlets, because patients are identified by a health insurance plan and an unique identifier for that health insurance (not outlet identifiers as described above), a PBM cannot track cash transactions, or transactions related to insurance plans not serviced by that PBM. Thus, the PBM also cannot provide an accurate depiction of a physician's dispensing habits.
What is needed is an efficient and effective way to track a patient's pharmaceutical prescriptions (sales) across a period of time and across outlets where all prescription information related to a unique patient can be linked regardless of the data source for the information.